Cognitive behavioral therapy in practice: therapist perceptions of techniques,outcome measures,practitioner qualifications,and relation to research

Cognitive behavioral therapy (CBT) has a strong evidence base for several psychiatric disorders, however, it may be argued that currently there is no overall agreement on what counts as ‘CBT’. One reason is that CBT is commonly perceived as encompassing a broad range of treatments, from purely cognitive to purely behavioral, making it difficult to arrive at a clear definition. The purpose of the present study was to explore practicing therapists’ perceptions of CBT. Three hundred fifty members of two multi-disciplinary interest groups for CBT in Sweden participated. Mean age was 46 years, 68% were females, 63% psychologists and mean number of years of professional experience was 12 years. Participants completed a web-based survey including items covering various aspects of CBT practice. Overall, therapist perceptions of the extent to which different treatment techniques and procedures were consistent with CBT were in line with current evidence-based CBT protocols and practice guidelines, as were therapists’ application of the techniques and procedures in their own practice. A majority of participants (78%) agreed that quality of life or level of functioning were the most important outcome measures for evaluating treatment success. Eighty percent of therapists believed that training in CBT at a basic level was a requirement for practicing CBT. There was a medium size Spearman correlation of r_s=.46 between the perceived importance of research to practice and the extent to which participants kept themselves updated on research. Implications for training, quality assurance, and the effectiveness of CBT in clinical practice are discussed.     

A group-level model of safety climate: testing the effect of group climate on microaccidents in manufacturing jobs

This article presents and tests a group-level model of safety climate to supplement the available organization-level model. Climate perceptions in this case are related to supervisory safety practices rather than to company policies and procedures. The study included 53 work groups in a single manufacturing company. Safety climate perceptions, measured with a newly developed scale, revealed both within-group homogeneity and between-groups variation. Predictive validity was measured with a new outcome measure, microaccidents, that refers to behavior-dependent on-the-job minor injuries requiring medical attention. Climate perceptions significantly predicted microaccident records during the 5-month recording period that followed climate measurement, when the effects of group- and individual-level risk factors were controlled. The study establishes an empirical link between safety climate perceptions and objective injury data.     

Grouping in short-term verbal memory: Is position coded temporally?

The nature of the mechanisms that code item position in serial short-term verbal recall was investigated with reference to temporal grouping phenomena--effects that arise when additional pauses are inserted in a presented list to form groups of items. Several recent models attempt to explain these phenomena by assuming that positional information is retained by associating items with contextual information. According to two of the models--the Phonological Loop model (Hitch, Burgess, Towse, & Culpin, 1996) and the OSCAR model (Brown, Preece, & Hulme, 2000)--contextual information depends critically on the timing of item presentation with reference to group onset. By contrast, according to the Start-End model (Henson, 1998) and a development from it, which we label the Oscillator-Revised Start-End model (Henson & Burgess, 1997), contextual information is independent of time from group onset. Three experiments examined whether coding of position is time dependent. The critical manipulation was to vary stimulus-onset asynchrony from one group to the next in the same list. Lists of consonants were presented visually, but with vocalization in Experiment 1, auditorily in Experiment 2, and auditorily with articulatory suppression in Experiment 3. The pattern of order errors consistently favoured the predictions of the time-independent models over those of the time-dependent models in that across-group transpositions reflected within-group serial position rather than time from group onset. Errors involving intrusions from previous lists also reflected within-group serial position, thereby extending support for the time-independent models.     

Climate strength: a new direction for climate research

Climate strength was conceptualized within D. Chan's (1998) discussion of compositional models and the concept of culture strength from the organizational culture literature. Climate strength was operationalized in terms of within-group variability in climate perceptions-the less within-group variability, the stronger the climate. The authors studied climate strength in the context of research linking employee service climate perceptions to customer satisfaction. The hypothesis was tested that climate strength moderates the relationship between employee perceptions of service climate and customer satisfaction experiences. Partial support for the hypothesis was reported in both a concurrent and predictive (3-year) test across 118 branches of a bank. In the predictive study only the interaction of climate and climate strength predicted customer satisfaction. Implications for future research on climate and climate strength are discussed.     

Testing intergroup concordance in ranking experiments with two groups of judges

Across many areas of psychology, concordance is commonly used to measure the (intragroup) agreement in ranking a number of items by a group of judges. Sometimes, however, the judges come from multiple groups, and in those situations, the interest is to measure the concordance between groups, under the assumption that there is some within-group concordance. In this investigation, existing methods are compared under a variety of scenarios. Permutation theory is used to calculate the error rates and the power of the methods. Missing data situations are also studied. The results indicate that the performance of the methods depend on (a) the number of items to be ranked, (b) the level of within-group agreement, and (c) the level of between-group agreement. Overall, using the actual ranks of the items gives better results than using the pairwise comparison of rankings. Missing data lead to loss in statistical power, and in some cases, the loss is substantial. The degree of power loss depends on the missing mechanism and the method of imputing the missing data, among other factors.     

Provider,Caretaker, Nurturer,Hero: Perceptions of Parenting Changes among Women Who Experienced Intimate Partner Violence

In this study, we examined changes in mothers’ reports of discipline, nurturing, and parenting satisfaction, along with their perceptions of how intimate partner violence (IPV) affected their role as a mother. Data were gathered from 85 women (86% identified as non-Hispanic White; mean age?=?31.7 years; average number of children?=?2.5) across three data waves. We used a convergent parallel mixed method design to examine women’s parenting experiences. Two standardized scales assessed parenting discipline, nurturance, and satisfaction. Five additional items assessed perceptions of how IPV influenced parenting. Women responded to open-ended questions about perceptions of their mothering role and how IPV influenced this role over time. We found significant changes in discipline scores and women’s ability to have their desired relationship with their children. Nurturing and parenting satisfaction scores did not significantly change over time. Four themes emerged for women’s role as mothers: provider and nurturer, teacher and discipliner, challenges, and importance of the mother role. Seven themes emerged on how IPV influenced mothering: ability to be present, trouble with discipline, overcompensation and overprotective, learned behavior, no impact, finding strength, and self-doubt. These findings contribute to the growing scholarship assessing women’s perceptions of their mothering roles and parenting in the context of IPV. Future research should examine the impact and nuances of parental interference in various contexts and over time.

     

The Reliability and Validity of the Religious Health Fatalism Scale in Turkish Language

This study aimed to conduct the reliability and validity study of the Religious Health Fatalism Scale in Turkish language. The study carried out in methodological type and consisted of 500 individuals. The basic component analysis was applied to the 17-item scale, and it was decided that the Turkish version of the scale would have one sub-dimension. Factor loads were over 0.30 for all items, and the explained variance of the scale was found 42.70%. The Cronbach’s α coefficient was determined to be 0.91. Consequently, it was determined that the Religious Health Fatalism Scale had one dimension in the Turkish language, and it was a highly valid and reliable tool. It was determined that the elderly, females, housewives, illiterate, people with no health insurance, married individuals, those with low income, and people with chronic diseases had higher health fatalism scores.

     

Reexamining the link between parental knowledge and delinquency: unpacking the influence of adolescents’ and their parents’ perceptions

ABSTRACT

Parents’ and their children’s perceptions of how much parents know about the child’s activities outside parental presence (parental knowledge) are important for understanding delinquency. Yet, conceptual and methodological deficiencies in prior research may limit this understanding. Reexamining how these perceptions affect delinquency, we find that contrary to conventional wisdom: (1) adolescent and parent perceptions of parental knowledge impact delinquency jointly rather than independently and (2) the protective effect of adolescent perceptions weakens as parent perceptions increase. Specifically, when parental perceptions are strongest, the delinquency inhibiting effect of adolescent perceptions is offset, which may result from stress of parents’ monitoring efforts.     

The importance of contextual variables when judging fairness: An examination of counterfactual thoughts and fairness theory

This research empirically examines the underlying mechanisms of fairness theory (  and ), namely counterfactual thought processes. Study 1 used a policy-capturing design to examine the relative importance of contextual variables in predicting counterfactual thoughts and fairness perceptions. Study 2 utilized a between-subjects design and asked participants to generate their own counterfactuals in response to an unfortunate event. Results of both studies showed that fairness perceptions are influenced by contextual variables (i.e., outcome severity, target knowledge and expertise, sin of commission vs. omission) and counterfactual thinking. Counterfactual thoughts partially mediated the effects of contextual variables and fairness perceptions in Study 1. Exploratory analyses from Study 3 revealed that the measurement of counterfactual thoughts (frequency vs. strength) may capture different underlying constructs. Implications are discussed.     

Perceptions of and Attitudes toward Plagiarism and Factors Contributing to Plagiarism: a Review of Studies

The abundance of information technology and electronic resources for academic materials has contributed to the attention given to research on plagiarism from various perspectives. Among the issues that have attracted researchers’ attention are perceptions of plagiarism and attitudes toward plagiarism. This article presents a critical review of studies that have been conducted to examine staff’s and students’ perceptions of and attitudes toward plagiarism. It also presents a review of studies that have focused on factors contributing to plagiarism. Our review of studies reveals that most of the studies on perceptions of plagiarism and attitudes toward plagiarism lack an in-depth analysis of the relationship between the perceptions of plagiarism and other contextual, sociocultural and institutional variables, or the relationship between attitudes toward plagiarism and students’ perceptions of various forms of plagiarism. Although our review shows that various factors can contribute to plagiarism, there is no taxonomy that can account for all these factors. Some suggestions for future research are provided in this review article.     

Should We Agree to Disagree? The Multilevel Moderated Relationship Between Safety Climate Strength And Individual Safety Motivation

Organisational research investigating climate perceptions often use constructs reflecting dispersion and disagreement, termed ‘climate strength’, to investigate situational pressures on behaviour expression. Within safety-specific contexts, research has tended to emphasise the prediction of climate strength rather than an examination of its effects on behaviour. The present paper investigates the important first pathway in the prediction of safety behaviour by investigating the influence of safety climate strength on the relationship between safety climate perceptions and individual safety motivation in a safety critical context using multilevel analyses. Contrary to expectations, results initially indicated that safety climate strength negatively influenced the relationship between safety climate perceptions and safety motivation, such that greater variability was associated with greater motivation. Post hoc analysis re-grouping responses into broader functional levels found support for an interaction, suggesting a difference in the scope of influence for safety climate strength between the two levels of analysis. These findings are discussed in light of self-determination theory, and suggestions for future research and practice made.

     

Interpersonal Perceptions and Metaperceptions in Dialogic Action Therapy: A Relational Methodological Approach to Theory Construction

Abstract

Two forms of understanding in theories of therapy are identified: empathic understanding rooted in individualism, and reality-based understanding that acknowledges the relational character of human existence. We argue for regarding these two forms of understanding as complementary. This requires a paradigmatic shift from methodological individualism to methodological relationalism, which asserts that the analysis of role relationships precedes that of individuals and situations. Informed by methodological relationalism, dialogic action therapy accords prominence to the creation of a therapeutic relationship between therapist and client, between whom bidirectionality of perceptions is inherent. We develop a formal analytic scheme for theory building. Six major constructs, degrees of perception, directionality, agreement, reciprocity, accuracy, and congruence, are employed to facilitate the analysis of therapist and client perceptions and metaperceptions of trust in depth. The implications for therapy and methodology of measurement are discussed.     

Brain drawings following traumatic brain injury (TBI) and links to illness perceptions and health outcomes – Findings from a population-based study

Objective: Individuals’ illness perceptions predict health behaviours and influence functional outcomes. This study examined associations between a novel assessment of illness perceptions, in the form of adult’s brain drawings after traumatic brain injury (TBI) and questionnaire measures of illness perceptions, quality of life and post-concussive symptoms.

Design: Population-based, prospective longitudinal study examining 245 adults with predominantly mild TBI with high risk of complications.

Main outcome measures: Participants were asked to draw pictures of what they thought their brain looked like before injury and at baseline and one month post-injury. Drawing characteristics (height, width and percentage damage at one month) were examined in relation to each outcome of interest at six months.

Results: Greater damage at one month was associated with more negative illness perceptions (rs = .23), poorer mental health (rs = ?.21), and more total post-concussive symptoms (rs = .27 to r = .35) at six months. The extent of damage depicted reduced over time (p < .001). No associations were found between the amount of damage drawn and injury severity, nor the height or width of drawings and injury severity or illness perceptions.

Conclusion: Drawings post-TBI offer a simple, cost- and time-effective way to begin discussions and improve understanding of peoples’ illness perceptions.     

Stuck in the Middle: The Use and Interpretation of Mid-Points in Items on Questionnaires

Likert-type scales are commonly used when assessing attitudes, personality characteristics, and other psychological variables. This study examined the effect of varying the number of response options on the same set of 28 attitudinal items. Participants answered items using either a 4-point scale (forced choice), a 5-point scale that included a “neither” mid-point, or a 4-point scale with an option of “no opinion” presented after the item. The questionnaire also included an item asking participants what they believe the midpoint in a scale indicated. As predicted, participants’ interpretations of the midpoint varied widely with the most common responses being: “no opinion,” “don't care,” “unsure,” “neutral,” “equal/both,” and “neither.” The quantitative results showed that participants’ levels of item endorsement varied based on the response options offered. For example, “neither” was chosen more often than “no opinion” on all of the items.     

Radical Behaviorism,Stimulus Equivalence,and Human Cognition

The current paper represents an attempt to clarify the nature of the radical behaviorist’s perspective on human cognition. This attempt will involve an examination of recent behavioral research into the relationship between stimulus equivalence phenomena and symbolic behavior, and language more generally. This form of behavior analysis is offered as an alternative to, but not a replacement for, other methodological and conceptual approaches to psychology.

     

An Integrative Model of Updating and Performance

Under conditions of rapid technological innovation, maintaining the technical competence of a firm's human resources becomes critical. This research developed a theoretical framework and model for updating. It was proposed that individual characteristics and contextual features would jointly affect perceptions of the job and the climate for updating. The perceptions would, in mm, mediate the relationship between the contextual features and individual responses of performance and updating. Data gathered from 483 engineers drawn from 220 subunits across seven organizations provided partial support. Context measures were significantly mediated by the perceptions. Individual characteristics, however, were directly linked to performance and updating responses. The results suggest that attempts to influence performance and updating may require modifications to the techno-structural aspects of work.     

Using a Difficulty‐Anchored Rating Scale in Performing Angoff Ratings

While the Angoff (1971) is a commonly used cut score method, critics ( Berk, 1996; Impara & Plake, 1997 ) argue the Angoff places too‐high cognitive demands on raters. In response to criticisms of the Angoff, a number of modifications to the method have been proposed. Some suggested Angoff modifications include using an iterative rating process, presenting judges with normative data about item performance, revising the rating judgment into a Yes/No decision, assigning relative weights to dimensions within a test, and using item response theory in setting cut scores. In this study, subject matter expert raters were provided with a ‘difficulty anchored’ rating scale to use while making Angoff ratings; this scale can be viewed as a variation of the Angoff normative data modification. The rating scale presented test items having known p‐values as anchors, and served as a simple means of providing normative information to guide the Angoff rating process. Results are discussed regarding reliability of the mean Angoff rating (.73) and the correlation of mean Angoff ratings with item difficulty (observed r ranges from .65 to .73).     

Operational Sequence in Group Therapy with Young Offenders

Abstract

Attachment has increasingly been identified as central to therapy process and outcome. Attachment theory proposes that an individual’s prior interactions with attachment figures develop into templates that will guide the way they form connections and perceive their relationships with others. This study examined clients’ ratings of their relationship with the therapist as well as their ratings of group climate at multiple discrete points during treatment. These variables were examined in relation to attachment classification prior to therapy. Participants were 62 women attending the Women Recovering from Abuse Program (WRAP), a primarily group-based day-treatment program for childhood interpersonal trauma, at Women’s College Hospital in Toronto, Ontario, Canada. Results demonstrated that clients’ perceptions of relationships in group therapy varied as a function of attachment classification.     

Illusory correlations in perceptions and predictions of organizational traits

People often believe in ‘illusory’ correlations between variables that are similar, but not actually correlated. This study suggests that judgments of organizational traits reflect illusory correlations, because subjects' perceptions of correlations between traits, and the predictions of Hage's (1965) ‘axiomatic’ theory, were more highly correlated with independent similarity ratings than with actual correlations between traits. Some methodological reasons why organizational-trait theories might unwittingly produce illusory correlation predictions are discussed, along with possible remedies.